Individual provider Active NPI

Jennifer Dawn Jackson Filson, AU.D., CCC-A

  • Audiologist
  • Frankfort, IN
National Provider Identifier
1508826835
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
23002275A Issued in IN
Practice address
2485 E Wabash St Ste 110
Frankfort, IN 46041
Phone
(765) 659-7400
Fax
(765) 659-7408
NPI assigned
Mar 23, 2006
Last updated
Aug 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 23002275A IN Primary

Addresses

Primary practice location

2485 E Wabash St Ste 110
Frankfort, IN 46041

Mailing address

2705 N Lebanon St Ste 305
Lebanon, IN 46052-8622

Other practice location 1

2485 E Wabash St Ste 110
Frankfort, IN 46041
Phone (765) 485-8100

Other identifiers 1

IdentifierTypeStateIssuer
300023111MedicaidIN

Other names 1

  • Jennifer Dawn Jackson Moore Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080708000025 IN Practitioner - Qualified Audiologist 3274605399 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23002275AINMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Witham Memorial Hospital Current Accepting new patients
Witham Memorial Hospital CurrentSince Jan 1, 2019 Accepting new patients
Witham Memorial Hospital Audiologist CurrentSince Jan 1, 2019 Accepting new patients

Locations

2485 E Wabash St
Ste 110
Frankfort, IN 46041
Phone (765) 485-8100

2505 N Lebanon St
Ste 220
Lebanon, IN 46052
Phone (765) 482-8649

2705 N Lebanon St
Ste 305
Lebanon, IN 46052
Phone (765) 485-8677

400 N Mount Zion Rd
Lebanon, IN 46052
Phone (765) 335-0123

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1508826835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 N LEBANON ST STE 305",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460528622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 E WABASH ST STE 110",
            "city": "FRANKFORT",
            "state": "IN",
            "postal_code": "46041",
            "telephone_number": "765-659-7400",
            "fax_number": "765-659-7408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2485 E Wabash St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Frankfort",
            "state": "IN",
            "postal_code": "46041",
            "country_code": "US",
            "telephone_number": "765-485-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON FILSON",
        "first_name": "JENNIFER",
        "middle_name": "DAWN",
        "credential": "AU.D., CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002275A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300023111",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "JACKSON MOORE",
            "middle_name": "DAWN",
            "credential": "AU.D., CCC-A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Frankfort, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.